Permethrin
Pronouncation: (per-METH-rin)Class: Scabicides, Pediculicides
Trade Names:
Acticin
- Cream 5%
Trade Names:
Elimite
- Cream 5%
Trade Names:
Permethrin
- Lotion 1%
Nix Dermal Cream (Canada)
Pharmacology
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Acts on the nerve cell membrane to disrupt the sodium channel current by which the polarization of the membrane is regulated. Delayed repolarization and paralysis of the pests is the outcome.
Pharmacokinetics
Metabolism
Rapidly metabolized by ester hydrolysis to inactive metabolites.
Elimination
Excreted primarily in the urine.
Indications and Usage
CreamTreatment of scabies ( Sarcoptes scabiei ) infestation.
Lotion/Cream rinseTreatment of infestation with head lice ( Pediculus humanus capitis ) and its nits (eggs).
Contraindications
Standard considerations.
Dosage and Administration
ScabiesCream Massage 30 g into the skin from head to soles of feet. Massage into hairline, neck, temple, and forehead of infants and elderly patients. Remove cream by shower or bath after 8 to 14 h. One application is generally curative.
Head LiceLotion/Cream rinse Apply to hair after washing with shampoo; rinse with water, and towel dry. Apply a sufficient amount to saturate hair and scalp, especially behind the ears and nape of neck. Leave on hair for no longer than 10 min, then rinse with water. If lice are observed within 7 days after application, apply a second treatment. Remove remaining nits with nit comb provided.
General Advice
- For topical use only. Not for ophthalmic, oral, or intravaginal use.
- Avoid contact with eyes. If eye contact occurs, flush immediately and thoroughly with water.
Storage/Stability
Store at controlled room temperature (59° to 77°F).
Drug Interactions
None well documented.
Laboratory Test Interactions
None well documented.
Adverse Reactions
CNS
CreamDizziness (5%), headache, seizure (rare) (postmarketing).
Dermatologic
CreamMild transient burning/stinging (10%); itching (7%); tingling, numbness, erythema, rash (2% or less).
Lotion/Cream rinseItching, redness, swelling of scalp.
GI
CreamAbdominal pain, diarrhea, nausea, vomiting (5% [postmarketing]).
Miscellaneous
CreamFever (5% [postmarketing]).
Precautions
Pregnancy
Category B .
Lactation
Undetermined.
Children
Safety and efficacy not established in patients younger than 2 months of age.
Asthmatic patients
May cause breathing difficulties or exacerbate asthmatic episodes.
Dermatological effects
Elimite may temporarily exacerbate pruritus, edema, and erythema and is rarely a sign of treatment failure.
Patient Information
- Caution patient or caregiver to avoid contact with eyes and if accidental eye contact occurs, immediately flush the eyes with water to remove medication. Advise patient or caregiver to notify health care provider if eye irritation or sensitivity follows exposure to the eyes.
- Teach patient or caregiver proper technique for applying cream: wash hands; use gloves if applying to another person; thoroughly massage cream into skin from the head to the soles of the feet; 8 to 14 h after application, remove cream by washing (shower or bath).
- Advise patient or caregiver that itching, mild burning, and/or stinging may occur after application of cream but that this should go away in 2 to 4 wk. If irritation persists, advise patient to notify health care provider.
- For proper nit removal, wash all personal articles and clothing (eg, coats, linen, combs, headgear) in hot water or seal in a plastic bag for approximately 2 wk. Thorough vacuuming of rooms is recommended.
- Advise patient to discontinue use and consult health care provider if irritation persists or infection is present or develops.
- Consult health care provider if infestation of eyebrows or eyelashes occur.
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More Permethrin resources:
Nix Cream Rinse Topical - Includes detailed dosage instructions.
